Fourteen years of manifestations and factors of health insurance fraud, 2006–2020: a scoping review

Background Healthcare fraud entails great financial and human losses; however, there is no consensus regarding its definition, nor is there an inventory of its manifestations and factors. The objective is to identify the definition, manifestations and factors that influence health insurance fraud (HIF). Methods A scoping review on health insurance fraud published between 2006 and 2020 was conducted in ACM, EconPapers, PubMed, ScienceDirect, Scopus, Springer and WoS. Results Sixty-seven studies were included, from which we identified 6 definitions, 22 manifestations (13 by the medical provider, 7 by the beneficiary and, 2 by the insurance company) and 47 factors (6 macroenvironmental, 15 mesoenvironmental, 20 microenvironmental, and 6 combined) associated with health insurance fraud. We recognized the elements of fraud and its dependence on the legal framework and health coverage. From this analysis, we propose the following definition: “Health insurance fraud is an act of deception or intentional misrepresentation to obtain illegal benefits concerning the coverage provided by a health insurance company”. Among the most relevant manifestations perpetuated by the provider are phantom billing, falsification of documents, and overutilization of services; the subscribers are identity fraud, misrepresentation of coverage and alteration of documents; and those perpetrated by the insurance company are false declarations of benefits and falsification of reimbursements. Of the 47 factors, 25 showed an experimental influence, including three in the macroenvironment: culture, regulations, and geography; five in the mesoenvironment: characteristics of provider, management policy, reputation, professional role and auditing; 12 in the microenvironment: sex, race, condition of insurance, language, treatments, chronic disease, future risk of disease, medications, morale, inequity, coinsurance, and the decisions of the claims-adjusters; and five combined factors: the relationships between beneficiary-provider, provider-insurance company, beneficiary-insurance company, managers and guānxi. Conclusions The multifactorial nature of HIF and the characteristics of its manifestations depend on its definition; Identifying the influence of the factors will support subsequent attempts to combat HIF.

Symbolic and Numeric Kernel Division for GPU-based FEA Assembly of Regular Meshes with Modified Sparse Storage Formats

This paper presents an efficient strategy to perform the assembly stage of finite element analysis (FEA) on general-purpose graphics processing units (GPU). This strategy involves dividing the assembly task by using symbolic and numeric kernels, and thereby reducing the complexity of the standard single-kernel assembly approach. Two sparse storage formats based on the proposed strategy are also developed by modifying the existing sparse storage formats with the intention of removing the degrees of freedom-based redundancies in the global matrix. The inherent problem of race condition is resolved through the implementation of coloring and atomics. The proposed strategy is compared with the state-of-the-art GPU-based and CPU-based assembly techniques. These comparisons reveal a significant number of benefits in terms of reducing storage space requirements and execution time and increasing performance (GFLOPS). Moreover, using the proposed strategy, it is found that the coloring method is more effective compared to the atomics-based method for the existing as well as the modified storage formats.

Software architecture for display controller and operating system interaction

Article describes solutions for developing programs that provide interaction between Linux operating system and multiple display controller hardware blocks (outputs), that use one clock generation IP-block with phase-locked loop (PLL). There is no API for such devices in Linux, thus new software model was developed. This model is based on official Linux GPU developer driver model, but was modified to cover case described earlier. Article describes three models for display controller driver development – monolithic, component and semi-monolithic. These models cannot cover case described earlier, because they assume that one clock generator should be attached to one output. A new model was developed, that is based on component model, but has additional mechanics to prevent race condition that can happen while using one clock generator with multiple outputs. Article also presents modified model for bootloaders graphics drivers. This model has been simplified over developed Linux model, but also has component nature (with less components) and race prevention mechanics (but with weaker conditions). Hardware interaction driver components that are developed using provided software models are interchangeable between Linux and bootloader.

Selection of Posture for Time-Trial Cycling Events

Cyclists usually define their posture according to performance and comfort requirements. However, when modifying their posture, cyclists experience a trade-off between these requirements. In this research, an optimization methodology is developed to select the posture of cyclists giving the best compromise between performance and comfort. Performance was defined as the race time estimated from the power delivery capacity and resistive forces. Comfort was characterized using pressure and vibration indices. The optimization methodology was implemented to select the aerobars’ height for five cyclists riding on 20-km time-trial races with different wind speed and road grade conditions. The results showed that the reduction of the aerobars’ height improved the drag area (−10.7% ± 3.1%) and deteriorated the power delivery capacity (−9.5% ± 5.4%), pressure on the saddle (+16.5% ± 11.5%), and vibrations on the saddle (+6.5% ± 4.0%) for all the tested cyclists. It was observed that the vibrations on the saddle imposed the greatest constraint for the cyclists, limiting the feasible exposure time and, in some cases, modifying the result obtained if the posture was selected considering only performance. It was concluded that optimal posture selection should be performed specifically for each cyclist and race condition due to the dependence of the results on these factors.

Challenge Accepted? Individual Performance Gains for Motor Imagery Practice with Humanoid Robotic EEG Neurofeedback

Optimizing neurofeedback (NF) and brain–computer interface (BCI) implementations constitutes a challenge across many fields and has so far been addressed by, among others, advancing signal processing methods or predicting the user’s control ability from neurophysiological or psychological measures. In comparison, how context factors influence NF/BCI performance is largely unexplored. We here investigate whether a competitive multi-user condition leads to better NF/BCI performance than a single-user condition. We implemented a foot motor imagery (MI) NF with mobile electroencephalography (EEG). Twenty-five healthy, young participants steered a humanoid robot in a single-user condition and in a competitive multi-user race condition using a second humanoid robot and a pseudo competitor. NF was based on 8–30 Hz relative event-related desynchronization (ERD) over sensorimotor areas. There was no significant difference between the ERD during the competitive multi-user condition and the single-user condition but considerable inter-individual differences regarding which condition yielded a stronger ERD. Notably, the stronger condition could be predicted from the participants’ MI-induced ERD obtained before the NF blocks. Our findings may contribute to enhance the performance of NF/BCI implementations and highlight the necessity of individualizing context factors.

Race Condition Detection Algorithms

A data race is similar to any other bugs in software application. Data race will result in the execution of the program unpredictable. There are 46 documented races in Linux kernel. OpenMP is an Application programming interface for shared programming model. It is a construct based model which works on fork join parallelism. OpenMP achieved node level parallelism and can manage data in single instruction multiple data and single program multiple data parallelism by executing different constructs like work sharing and parallel constructs. In any shared programming model, variables are shared by multiple threads in the program to execute different tasks by different threads. OpenMP is used to achieve parallelism by creating shared variable environment but there are chances to have data races in OpenMP programs. In this paper we discuss different algorithms to detect data races in OpenMP programs.